Sr Manager of Accreditation Administration

Job ID: AK-1018860 Description:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants.We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can email us here to request reasonable accommodations.

Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "my account" and click on "View your job submissions".

JOB PURPOSE:

This position is responsible for managing accreditation efforts for the Enterprise Quality & Accreditation department. This involves managing the administration of activities that comply with accreditation standards (NCQA, URAC), federal regulations (ACA, CMS / Medicare and Medicaid), and Plan state regulations. Responsible for one (1) or more of the following: Accreditation Analysis, Accreditation Oversight & Monitoring, Accreditation Federal & State Oversight, Accreditation Policies & Procedures.

REQUIRED JOB QUALIFICATIONS:

  • Bachelor degree and 7 years of health care administration, business operations, or project management.
  • Experience in the interpretation and application of health care accreditation standards. Analytical skills and negotiation skills.
  • Knowledge of Continuous Quality Improvement (CQI) concepts, Strategy, and Change Management concepts.
  • Knowledge and experience in the interpretation and application of external accrediting agency requirements (i.e., NCQA, URAC, AAAHC).
  • Knowledge of Health Care Industry business processes and functions.
  • Experience providing support to senior-level staff in process reengineering and strategic problem solving.
  • Knowledge of enterprise business operations and experience leading cross-functional projects/project teams.
  • Written and verbal communication skills including professional presentation, decision-making, and interpersonal skills.
  • Analytical skills and negotiation skills. Leadership skills.
  • Organizational skills and detail oriented.
  • PC proficiency including Microsoft Office.
  • Ability and willingness to travel including overnight stays.

PREFERRED JOB QUALIFICATIONS:

  • Bachelor degree in the health care field.
  • Master degree.
  • Project management (PMP) Certification.
  • Registered Nurse (RN) Knowledge of HCSC business process model and organizational functions.
  • Experience with quality improvement and/or accreditation implementation strategies and initiatives.
  • Management experience.

LI - POST

  • CA
  • CB

Requirements: Expertise Regulatory & Compliance Job Type Full-Time Regular Location IL - Chicago, TX - Richardson, NM - Albuquerque


Meet Some of HCSC's Employees

Allison M.

Internal Auditor

Allison audits operational and financial data throughout the business, helping to expose and mitigate risks, ensure compliance, and add value to HCSC’s operations as a whole.

Rosa Y.

Claims Examiner

Rosa works to process claims that stop due to system edits—researching the edits, correcting the errors, and completing the claims to help members and providers get paid.


Back to top